Helen Salisbury: The perils of deprescribingBMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l666 (Published 19 February 2019) Cite this as: BMJ 2019;364:l666
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Re: Helen Salisbury: The perils of deprescribing : Vulnerable population with intellectual disabilities and behaviour disorders
Certain population are more vulnerable in the prescribing and the de-prescribing process.
One such population is the population with intellectual disabilities and behaviour disorders.
The principles below may be of value when attempting de prescribing in this vulnerable population.
Principles of Good De-prescribing during Medication Review in the Population with Intellectual Disabilities and Behaviour Disorders. Based on the British Pharmacological Society’s Principles for Good Prescribing 2010
1. Be clear about the reasons for de-prescribing.
2. Take into account the patient with intellectual disabilities and behaviour disorders medication history before de-prescribing.
3. Take into account other factors that might alter the benefits and risks of de-prescribing treatment in the patient with intellectual disability and behaviour disorders.
4. Take into account the patient’s/carer’s/families/advocates ideas, concerns, and expectations.
5. Ensure all medicines are effective, safe, cost-effective in appropriate form individualised for the patient with intellectual disability, behaviour disorders and other conditions such as dysphagia, autism.
6. Adhere to national guidelines and local formularies where appropriate. Use caution where the population with intellectual disability have not been considered in the guideline development process.
7. Write unambiguous correct documentation detailing reason for de-prescribing.
8. Monitor the beneficial and adverse effects of de-prescribing medicines and any effects on behaviour.
9. Communicate and document all de-prescribing decisions and the reasons for them such as transferred to appropriate personnel such as GP, pharmacist, psychiatrist, epileptologist, carer and patient.
10. De - prescribe within the limitations of your knowledge, skills and experience of the population with intellectual disabilities and behaviour disorders
Competing interests: No competing interests